The overarching goal of this project is to determine the cognitive, neuroanatomic and physiological underpinnings of the profound deficits in behavioral regulation exhibited by patients with behavioral variant frontotemporal dementia (bvFTD). Patients with bvFTD and other frontal lobe disorders often present with severe behavioral dysfunction despite relatively intact performance on standard clinical measures of attention, working memory, problem solving, and executive function. A primary question is to what degree these behaviors reflect deficits in cognition (e.g., cognitive control, awareness of errors, error correction), or whether they reflect a primary underlying deficit in the processing of reward and punishment. We propose to study 50 patients with mild bvFTD, 50 Alzheimer's disease patients matched for demographics and dementia severity, and 50 normal controls. We will study the cognitive components of behavioral regulation by assessing conflict monitoring, error detection, and error correction, and we will evaluate the motivational components by employing reward processing paradigms. Behavioral studies will be carried out in conjunction with functional MRI to study the brain systems that mediate these behaviors. Our results will hopefully shed light on why these patients fail to inhibit inappropriate actions and offer guidance toward new interventions. PUBLIC HEALTH RELEVANCE: The Inability to control impulses and inhibit inappropriate behavior has a devastating impact on patients with frontal lobe disorders. The overarching goal of this project is to study patients with behavioral-variant frontotemporal dementia to better understand the cognitive and neurological underpinnings of these maladaptive behaviors. The potential contribution to public health lies in the hope that a better understanding of the neural systems that mediate behavioral dyscontrol will lead to improvements in care.